Do you experience pain on the inner side of your knee, particularly when climbing stairs, walking, exercising or getting up from a chair? These symptoms may be associated with pes anserine bursitis, a condition affecting a small fluid-filled sac located below the inner knee joint.

The pain may develop gradually and become more noticeable during everyday activities. Some people also experience tenderness or swelling in the affected area.

Pes anserine bursitis can affect athletes, physically active individuals and people who experience repeated stress around the knee.

Understanding the condition and managing activities appropriately can help reduce discomfort and support recovery.

If you are experiencing persistent inner knee pain in Modbury North or surrounding Adelaide suburbs, this guide explains the causes, symptoms and seven practical ways to manage pes anserine bursitis.

What Is Pes Anserine Bursitis?

Pes anserine bursitis occurs when the small bursa located on the inner side of the knee becomes irritated.

A bursa is a small, fluid-filled sac that helps reduce friction between bones, tendons and surrounding soft tissues.

The pes anserine bursa is located between the shinbone (tibia) and the tendons of three muscles:

• Sartorius.

• Gracilis.

• Semitendinosus.

These tendons come together near the upper inner portion of the shinbone. Their arrangement resembles a goose’s foot, which is why the structure is called the pes anserinus.

When the bursa becomes irritated, it may cause localised pain and tenderness.

The condition is sometimes referred to as pes anserinus bursitis or pes anserine bursitis of the knee.

Common Causes and Risk Factors of Pes Anserine Bursitis

Pes anserine bursitis can develop when repeated friction, pressure or excessive loading affects the tissues around the inner knee.

Several factors may contribute to the condition.

1. Repetitive Physical Activity

Activities involving repeated knee movements can increase stress around the pes anserine region.

Examples include:

• Running.

• Cycling.

• Swimming.

• Playing football.

• Climbing hills.

• Repeated stair climbing.

Athletes who frequently bend and straighten their knees may be more likely to experience irritation in this area.

2. Sudden Increase in Exercise Intensity

Increasing your training distance, speed or frequency too quickly can place additional demands on the knee.

For example, suddenly increasing running mileage or starting an intensive exercise programme without adequate preparation may contribute to symptoms.

3. Tight Hamstring Muscles

The hamstring muscles attach around the back and inner side of the knee.

Reduced flexibility or increased tension in these muscles may contribute to discomfort around the pes anserine region.

4. Knee Alignment Differences

Certain lower-limb alignment patterns, including knock knees, may influence how forces are distributed around the knee.

These factors can contribute to increased stress on surrounding tissues in some individuals.

5. Existing Knee Conditions

People with knee osteoarthritis may also experience pes anserine bursitis.

The two conditions can occur together, although they affect different structures.

6. Other Contributing Factors

Additional factors associated with pes anserine bursitis include:

• Being overweight or obese.

• Diabetes.

• Previous knee injuries.

• Inappropriate training techniques.

• Repeated pressure around the inner knee.

The exact cause varies between individuals, and several factors may contribute simultaneously.

Common Symptoms of Pes Anserine Bursitis

The most noticeable symptom is usually pain on the inner side of the knee, approximately 2–3 inches below the knee joint.

Symptoms may include:

• Inner knee pain: Discomfort below the inner knee joint.

• Tenderness: Pain when pressing the affected area.

• Stair-climbing discomfort: Increased pain when walking upstairs or downstairs.

• Pain during exercise: Symptoms may worsen while running, cycling or performing repetitive knee movements.

• Difficulty standing up: Discomfort when getting up from a chair.

• Stiffness: The knee may feel uncomfortable after sitting with it bent for an extended period.

• Local swelling: Some individuals may notice mild swelling around the affected area.

Symptoms can develop gradually and may become more noticeable when physical activity increases.

7 Helpful Ways to Manage Pes Anserine Bursitis

Managing pes anserine bursitis involves reducing irritation around the affected area while gradually restoring knee strength and movement.

The following strategies may help.

1. Temporarily Modify Activities That Increase Pain

Continuing activities that repeatedly aggravate your symptoms may delay improvement.

Consider temporarily reducing:

• Long-distance running.

• Repeated hill climbing.

• Deep squats.

• Frequent stair climbing.

• High-intensity cycling.

• Exercises that cause increasing inner knee pain.

You do not necessarily need to stop all physical activity.

Choose comfortable alternatives, such as gentle walking on level surfaces, provided they do not significantly increase your symptoms.

2. Apply a Cold Pack

A cold pack may help manage discomfort around the affected area.

To use one safely:

• Wrap the cold pack in a thin towel.

• Apply it to the painful area for approximately 10–15 minutes.

• Avoid placing ice directly on your skin.

• Stop if you experience excessive discomfort or skin irritation.

Cold therapy may provide temporary symptom relief, but it does not address every underlying cause.

3. Avoid Prolonged Pressure on the Inner Knee

Direct pressure around the affected area may increase discomfort.

Try to:

• Avoid kneeling for extended periods.

• Use appropriate knee padding when kneeling is unavoidable.

• Take breaks during activities that place pressure on your knees.

• Change positions regularly.

• Avoid repeatedly pressing or massaging the painful area.

Small changes to daily activities may help reduce unnecessary irritation.

4. Maintain Comfortable Hamstring Flexibility

The hamstring muscles are connected to the pes anserine region.

A suitable flexibility programme may help address restricted movement and muscle tightness.

Depending on your symptoms, a physiotherapist may recommend gentle hamstring stretching.

Avoid forcing a stretch or continuing through sharp pain. The appropriate technique and intensity depend on your individual condition.

5. Strengthen the Muscles Supporting Your Knee

Strengthening the muscles around the knee can help improve lower-limb function and movement control.

A rehabilitation programme may include exercises targeting:

• Quadriceps.

• Hamstrings.

• Hip muscles.

• Gluteal muscles.

• Calf muscles.

Possible exercises include:

• Straight-leg raises.

• Supported mini squats.

• Controlled sit-to-stand movements.

• Resistance-band exercises.

• Gentle knee extension exercises.

Exercise selection should be based on your symptoms, strength and physical ability.

Start with manageable movements and gradually increase the difficulty under appropriate guidance.

6. Gradually Return to Normal Activities

Once symptoms begin improving, you can gradually increase your activity levels.

Consider the following approach:

• Start with shorter walking distances.

• Increase exercise duration gradually.

• Avoid sudden increases in training intensity.

• Allow recovery time between demanding sessions.

• Monitor discomfort during and after activity.

If symptoms become noticeably worse or remain aggravated the following day, your activity level may need adjustment.

A gradual return to exercise can help improve your tolerance without unnecessarily irritating the affected area.

7. Consider Physiotherapy for Individualised Rehabilitation

Physiotherapy can help identify factors contributing to inner knee pain and develop an appropriate rehabilitation programme.

A physiotherapist may assess:

• Knee movement.

• Hamstring flexibility.

• Quadriceps strength.

• Hip and lower-limb strength.

• Knee alignment.

• Walking pattern.

• Activities that reproduce your symptoms.

Based on the assessment, treatment may include progressive strengthening, flexibility exercises, movement retraining and activity modification.

The aim is to improve knee function and help you return to everyday activities comfortably.

How Is Pes Anserine Bursitis Diagnosed?

Diagnosis usually involves reviewing your symptoms, medical history and physical examination findings.

A healthcare professional may ask:

• Where exactly do you experience knee pain?

• Does climbing stairs increase your discomfort?

• Do you experience pain below the inner knee joint?

• Have you recently increased your exercise routine?

• Have you experienced previous knee injuries?

• Does pressing the inner side of your knee reproduce the pain?

Physical Examination

A clinical examination may include:

• Checking tenderness around the pes anserine region.

• Assessing knee movement.

• Testing hamstring flexibility.

• Evaluating muscle strength.

• Assessing walking and lower-limb movement.

• Performing selected resisted movements.

The examination helps determine whether your symptoms are consistent with pes anserine bursitis or another condition affecting the inner knee.

Imaging Tests

Imaging is not always required to diagnose pes anserine bursitis.

However, a healthcare professional may recommend further investigations when symptoms are unusual, persistent or difficult to distinguish from other conditions.

These may include:

X-ray: May help identify underlying bone conditions, fractures or osteoarthritis.

Ultrasound: Can help assess the bursa and surrounding soft tissues.

MRI: May provide detailed information about the surrounding tendons, ligaments, cartilage and other knee structures.

Imaging findings should always be interpreted alongside clinical symptoms and examination results.

How Can Physiotherapy Help With Pes Anserine Bursitis?

Physiotherapy may play an important role in managing pes anserine bursitis through exercise rehabilitation, activity modification and education.

1. Improving Muscle Flexibility

A physiotherapist may assess hamstring and other lower-limb muscle flexibility.

Where appropriate, gentle stretching exercises can be introduced to improve comfortable movement.

2. Strengthening the Knee

Strengthening exercises may target the quadriceps, hamstrings and surrounding muscles.

Improving muscle capacity can help support everyday activities such as walking, standing and climbing stairs.

3. Improving Movement Control

Your physiotherapist may assess how your knee and hip move during activities.

Exercises can be selected to improve lower-limb coordination and control.

4. Managing Exercise Loads

A physiotherapist can help identify activities that increase symptoms and suggest suitable modifications.

This may include adjusting running distance, exercise intensity or training frequency.

5. Supporting a Gradual Return to Exercise

As your symptoms and strength improve, rehabilitation can progress towards more demanding activities.

These may include:

• Longer walks.

• Stair climbing.

• Cycling.

• Running.

• Recreational sports.

The progression should be based on your recovery and activity tolerance.

How Long Does Pes Anserine Bursitis Take to Improve?

Recovery time varies depending on the severity of symptoms, contributing factors and response to treatment.

Many people improve with appropriate activity modification and conservative management. Some cases settle within approximately six to eight weeks, while others may take longer.

Factors that may influence recovery include:

• Duration of symptoms.

• Current muscle strength.

• Exercise and work demands.

• Existing knee conditions.

• Consistency with rehabilitation.

• Individual response to treatment.

Persistent or worsening symptoms should be reassessed to check whether another condition may be contributing to the pain.

Pes Anserine Bursitis vs Knee Osteoarthritis: What Is the Difference?

Pes anserine bursitis and knee osteoarthritis can both cause knee pain, but they affect different structures.

The conditions can occur together. A proper assessment helps determine which structures may be contributing to your symptoms.

When Should You Seek Medical Advice?

Not all inner knee pain is caused by pes anserine bursitis.

Other conditions, including meniscus injuries, ligament injuries and stress fractures, can produce similar symptoms.

Arrange a professional assessment if you experience:

• Persistent inner knee pain.

• Increasing tenderness or swelling.

• Difficulty walking comfortably.

• Pain that interferes with everyday activities.

• Symptoms that do not improve with appropriate activity modification.

Seek urgent medical attention if your knee becomes hot, red and significantly swollen, particularly if you also have a fever or feel unwell.

You should also seek prompt assessment if you experience severe pain following an injury, cannot bear weight or cannot move your knee normally.

Frequently Asked Questions About Pes Anserine Bursitis

1. Where is pes anserine bursitis pain located?

Pain is usually located on the inner side of the knee, approximately 2–3 inches below the knee joint. The area may feel tender when touched.

2. What causes pes anserine bursitis?

It can develop due to repetitive knee movements, excessive physical activity, increased training intensity and irritation around the inner knee. Other contributing factors may include hamstring tightness and existing knee conditions.

3. Is walking good for pes anserine bursitis?

Gentle walking may be suitable if it does not significantly increase your symptoms. Temporarily reduce walking distance or intensity if longer walks aggravate the affected area.

4. Can pes anserine bursitis heal without surgery?

Many cases improve with non-surgical management, including activity modification, cold therapy when appropriate and physiotherapy. Surgery is rarely required.

5. Should I exercise with pes anserine bursitis?

Appropriate exercise may help improve strength and movement. However, exercises that cause increasing pain should be modified. A physiotherapist can recommend a programme based on your condition.

6. Is pes anserine bursitis the same as knee osteoarthritis?

No. Pes anserine bursitis affects a small bursa near the inner knee, whereas osteoarthritis involves changes in the joint cartilage and other joint structures. Both conditions can occur together.

7. Does physiotherapy help pes anserine bursitis?

Physiotherapy may help through strengthening, flexibility exercises, movement assessment and activity modification. Treatment is tailored to the individual’s symptoms and physical ability.

Physiotherapy for Inner Knee Pain in Modbury North, Adelaide

Pes anserine bursitis can make everyday activities such as walking, climbing stairs, exercising and standing up from a chair uncomfortable.

Understanding the condition and following an appropriate rehabilitation programme may help improve knee strength, movement and activity tolerance.

PAX Physiotherapy provides physiotherapy and exercise rehabilitation services in Modbury North, Adelaide, South Australia.

If persistent inner knee pain is affecting your daily activities, contact PAX Physiotherapy to enquire about an assessment and suitable treatment options.

PAX Physiotherapy – Modbury North, Adelaide

Address: Unit 2, 438 Montague Road, Modbury North SA 5092

Phone: 08 8333 8333

Mobile: 0499 999 636

Email: admin@paxphysiotherapy.com.au

Website: https://paxphysiotherapy.com.au/

Medical Disclaimer

This article provides general educational information and is not a substitute for professional medical advice, diagnosis or treatment. Inner knee pain can have several causes, and symptoms alone cannot confirm pes anserine bursitis. Consult a qualified healthcare professional for an appropriate assessment, particularly if pain is severe, persistent, worsening or associated with significant swelling or difficulty bearing weight.